With the release of exam results, there is always much social media discussion – commiserations for those that had difficulty passing, jubilation from those that did, and questions from the candidates in waiting about how they should approach the challenge.  What is often forgotten is that the exams are just a ‘slice’ of attaining Fellowship in General Practice – competency is a much broader concept than that – and if you hadn’t thought about that before, then it might help you plan your approach to the assessments.

The Competency Cake:


  1. Communication skills – language, patient-focus and empathy
  2. Applied knowledge – knowledge and clinical skills (and the necessary equipment)
  3. Population and context – diverse patient demographic, understanding of community
  4. Professional and ethical – self-care, mentorship, reflective practice
  5. Organisational and legal – confidentiality, time, record-keeping, practice management.


Step 1:  Setup the appropriate environment in which to cook the cake.

  • If you are not an experienced baker, ask someone to supervise you.   If you think you are, consider who you might need to ask for help if you have problems – before you start.
  • Ensure that you have all the ingredients that you need and that they are of good quality.
  • Make sure you organise all the equipment you might need.

Step 2:  Add the ingredients in the order specified in the recipe.  Follow the instructions.

  • Don’t add extra sugar if you’re running out of flour.   Don’t learn more applied knowledge if your communication skills are not adequate.  You can’t learn population health out of a textbook.
  • Sometimes the little omissions from the recipe can be crucial – if you forget to put in professionalism, ethics, or legal ingredients then it doesn’t matter how good your clinical knowledge is.

Step 3:  The most complex cakes time time and patience to make and cook.

  • Take the time to cook it properly.  A half-baked recipe will not win prize cake at the local show.  Allow time to prepare, then make, then time to think about how it went and what could be improved.

Step 4:  

  • Find someone to share the cake with and ask others how they would have prepared it.   Everyone will appreciate something different in the recipe.

As a Medical Educator, I do a lot of cooking for, and cooking with doctors.  I also get to eat great cake.  What I have seen is four approaches to baking:

  1. I don’t need to know how to bake so I’ll just go and buy one someone else had made and it should taste good.
  2. I’m not great at baking but someone’s written a recipe, it’s from a famous chef, so it must work.   I’ll just follow it to the letter by myself and it should work.
  3. I’ve done a bit of baking, but I’m not sure that my technique is good enough and I’m not sure I can access all the ingredients.   I’ll ask another chef to help me out when I need to.
  4. My last attempt at baking was a flop, so I’m going to do cooking course to hone my skills before I start and ask the chef so support me as I cook.

There is no absolutely fail-safe approach – because there are so many variables that go into cooking a cake.   Some doctors are naturally great chefs – even with basic recipes they can make a souffle by changing the method and altering the ingredients.  They have the confidence to do this because they know the recipe inside-out, and they have worked with all of the ingredients before and know how they fit together.  This takes time and lots of cake-baking.

Don’t just think about the physical ingredients that you need, but your experience as a cook, and what environment you’ll be cooking in – then engage the amount of assistance you need to make and share an awesome cake.

P.s.  I wrote a blog with similar content a while back –  Planning your exam run  – exercise is a great way to deal with eating too much cake!

Please feel free to comment.

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